Infectious Diseases

Section 1: Information about the writer

Mustafa Elsayed

ST3 Health Education Southwest/Severn Deanery currently rotating at University hospitals Bristol NHS Foundation Trust.

Section 2: Scope of practice in the UK:

• The program is dual specialty in infectious diseases and medical microbiology,
• Firstly the medical microbiology part involves two aspects; the laboratory part and the clinical part.
• You will learn set of skills that will help you understand sample collection, processing, reporting and making decision relevant to the clinical scenario under investigation. The clinical aspect of the job is then related to reporting these results of samples and giving clinical advice to colleagues looking after the patient with regard to antimicrobial chemotherapy, need for further investigations (imaging for example), duration of treatment and any infection control aspects if needed.
• Prescribing antimicrobial in UK is restricted and many broad-spectrum antibiotics cannot be prescribed unless authorised by a microbiologist.
• Microbiologist have minimal patient’s contacts, their main job is in the laboratory, they do have rounds and they do see patients sometimes and explain results and management plan but that is not on regular/daily basis.
• There will be rounds to critical areas (ICU, PICU, NICU) to discuss management plans of critically ill patients, required samples to be sent and suggest antimicrobial treatment based on that evidence.
• There are no invasive procedures involved in this specialty, however there are set of required laboratory skills which are not difficult to learn, all that is expected to change in the future as new techniques are invading the specialty now.
• The typical work day of a trainee will involve coming to work at 9, authorising microbiological results via a computer based system/software these will include urine cultures, wound swabs, stool samples, fluid samples collected from different sites, anything basically that has been cultured to look for microorganisms. Then at around 10 blood cultures are reviewed with on duty biomedical scientist, and clinical information of patients are reviewed, then phone call to ward physicians looking after those patients and advised them accordingly with potential sources, appropriate further investigations and optimum antimicrobial treatment to begin with and suggested narrow down if that’s possible.
• Afterwards there may be ward rounds to review patients who are unwell with severe infections or positive blood cultures.
• Phone calls are accepted from colleagues and advice are given throughout the working hours 9-5 pm.
• Oncalls are from home and work is done by phone calls mainly.
• Oncalls are variable, they can busy at times and you get to wake up few times during night time, most of the time are tolerable and you get the calls between 5 pm -10 pm and then it is mostly quite.
• The infectious disease part will involve covering clinics (viral hepatitis clinic, infected joints clinics, HIV clinics, returning travellers clinic, general infectious disease clinic … etc) the type of the clinic will differ according to the centre you work at. Some hospitals will have inpatients wards for Infectious diseases and as a trainee you will have to spend part of your rotation doing inpatient infectious diseases in such hospitals.